Editorial | Responsibility of healthcare workers
WHEN, A week ago, this newspaper reported that panicked nurses at the private Hargreaves Memorial Hospital refused to treat a patient with symptoms of COVID-19, we assumed it was an aberration. Jamaican healthcare professionals were just that – professional and caring people who, for the most part, are deeply dedicated to their jobs. The situation at Hargreaves would soon right itself as it asserted sensible protocols for handling COVID-19 cases.
Happily, it turned out, the patient, who happened to be a respected doctor, wasn’t suffering from COVID-19, the respiratory disease caused by the new coronavirus that, so far, has infected more than a million people globally and caused over 60,000 deaths, including three in Jamaica.
We remain unshakeable in our knowledge of the skills of Jamaica’s doctors and nurses and other healthcare professionals, and are strong in our presumption of their dedication to service.
We are, nonetheless, disturbed by what emerged at last Thursday’s hearing of Parliament’s new select committee on COVID-19, which, we hope, is representative of the attitude of a minuscule portion of the country’s healthcare team.
Jamaicans were informed by the health ministry’s senior epidemiologist, Karen Webster Kerr, that testing for COVID-19 is lagging because of the reluctance of healthcare professionals, which we presume to mean doctors and nurses, to do the nose and throat swabs required to detect the virus. “So, even if persons want to be tested, they are feared by the healthcare workers,” Dr Webster Kerr said.
The upshot is that the bulk of the tests for COVID-19, which are already relatively few, are being done by a handful of medical people. “The capacity is there (to test), but we are not getting the amount of samples…” She appealed for “volunteers to actually do the testing” at health facilities.
The health and wellness minister, Dr Christopher Tufton, empathised with the healthcare workers, “who are humans”, too, with their own fears and insecurities, who, like the rest of the society, are on a steep upward curve about the COVID-9 virus.
We, too, are empathetic, except that this is the health workers’ job, to which they are bound by an ethical and moral code to take actions that enhance the health, wellness and well-being of patients.
What Dr Webster Kerr must now do is identify how this reluctance to conduct the tests manifests itself, to determine whether it is an internal human resource management issue, or a matter for the Jamaica Medical Council, the Nursing Council of Jamaica, or other regulatory bodies.
Of course, we do not expect that nurses, doctors or other healthcare professionals to be injudicious when treating patients who may be infected with the COVID-19 virus. They must insist on having good quality personal protective equipment, and should follow protocols and guidance developed by the World Health Organization (WHO) and adapted to the domestic environment.
Further, it is much more than a high rate of testing for it, other than preventing its spread, which is the best protection for nurses, doctors, and other healthcare professionals against COVID-19. These professionals are at greater risk when large numbers of people become critically ill and require care in overburdened health facilities, as has happened in Italy and is emerging in the USA. Testing gives a sense of its prevalence, allowing policymakers to better plan interventions against its spread, thereby easing the burden on health facilities and the people who man them.
There is another likely negative spin-off from the attitude described by Dr Webster Kerr. If doctors and nurses are openly fearful of, and hostile towards, patients who may have COVID-19, they reinforce stigma and discrimination against persons with the virus. This may cause people to go underground, rather than reporting symptoms and risk not only quarantine, but discrimination.
Last week’s episode suggests that the health and wellness ministry has substantial work to do in developing, and properly executing, messages about COVID-19 that attack the problem - stigma and discrimination -even as they impel the society towards individual responsibility, and collective action, against the virus.